Vietnam Authority of HIV AIDS Control
Vietnam Authority of HIV AIDS Control
Auld A.F.,Center for Global Health |
Shiraishi R.W.,Center for Global Health |
Oboho I.,Center for Global Health |
Ross C.,Center for Global Health |
And 93 more authors.
Morbidity and Mortality Weekly Report | Year: 2017
What is already known about this topic? Monitoring prevalence of advanced human immunodeficiency virus (HIV) disease (i.e., CD4+ T-cell count <200 cells/µL) among persons initiating antiretroviral therapy (ART) is important to help understand ART program outcomes, inform HIV prevention strategies, and forecast need for adjunctive therapies. What is added by this report? In an analysis of 694,138 adult ART records from 10 countries, the prevalence of advanced disease at ART initiation during 2004-2015 declined in eight countries. In Mozambique (2004-2014), Namibia (2004-2012), and Haiti (2004-2015), prevalence of advanced disease at ART initiation declined from 73% to 37% (p<0.001), 80% to 41% (p<0.001), and 75% to 34% (p<0.001), respectively. In the remaining seven countries with data available for 2004-2011, significant declines in prevalence of advanced disease were observed in Nigeria, Swaziland, Uganda, Vietnam, and Zimbabwe. What are the implications for public health practice? Declines in the prevalence of advanced disease at ART enrollment over time in most countries are encouraging, but in 2015, approximately a third of new ART patients still initiated ART late. Adoption of World Health Organization-recommended “treat-all” guidelines and strategies to facilitate earlier HIV testing, and treatment are needed. These strategies would help reduce HIV-related mortality and HIV incidence. © 2017, Department of Health and Human Services. All rights reserved.
Pham Q.D.,Pasteur Institute |
Do N.T.,Vietnam Authority of HIV AIDS Control |
Le Y.N.,Centers for Disease Control and Prevention |
Nguyen T.V.,Pasteur Institute |
And 12 more authors.
Journal of Antimicrobial Chemotherapy | Year: 2015
Objectives: The objective of this study was to determine the prevalence and correlates of pretreatment drug resistance (PDR) to first-line antiretroviral drugs among people initiating therapy for HIV in Vietnam. Methods: Bloodwas collected during November 2009 to October 2010 from people consecutively initiating ART in four purposively selected public outpatient clinics in three Vietnamese cities. At each study site, recruitment lasted for 6-10 months until the target sample size (range 120-130 individuals) had been reached. The viral load was measured in 501 samples; 490 samples (viral load ≥1000 copies/mL) were genotyped using a nucleotide population-based sequencing assay. Self-reported demographic and clinical data were elicited through interviews. We classified drug-resistance-associated mutations (DRMs) according to the 2009 WHO surveillance list. Results: DRMs were identified in 17/490 participants (3.5%; 95% CI 2.2%-5.5%). The prevalence of DRMs was 1.6% (8/490) against NRTIs, 1.6% (8/490) against NNRTIs and 0.8% (4/490) against PIs; three (0.6%) participants were resistant to both NRTIs and NNRTIs. The overall prevalence of PDR to first-line drugswas low[2.7% (13/490); 95% CI 1.6%-4.4%]. The prevalence of PDR to first-line drugs was greater among 198 HIV-infected participants who injected drugs than among 286 participants who reported risks for sexually acquired HIV (4.0% versus 1.4%, P=0.079). Multivariable logistic regression analysis suggested that PDR to first-line drugs was significantly higher among people who injected drugs (OR=3.94; 95% CI 1.13-13.68). Conclusions: With low PDR, first-line ART may be effective in Vietnam and pretreatment genotyping may be unnecessary. Continuing strategies for the prevention and surveillance of antiretroviral resistance are important for maintaining a low prevalence of antiretroviral resistance in Vietnam. The association between resistance and injection drug use warrants further research. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.